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    Measuring Blood Sugar: The Eyes Have It


    Ultimately, says Klonoff, "Where all this technology is eventually heading is toward an artificial pancreas."

    The pancreas, the organ that produces the hormone insulin to metabolize glucose is not functional in people with diabetics. Creating a replacement organ is the Holy Grail of diabetes research. At the ADA meeting, French doctors reported early success in their bid to accomplish this.

    "It's based upon an insulin pump that is surgically implanted under the skin in the abdomen wall, providing a two- to three-month supply of the hormone insulin," explains lead researcher Eric Renard, MD, of the Hopital Lapeyronie in Montpellier, France. "And a glucose sensor is implanted by the jugular vein."

    The pump looks like a yo-yo; the insulin sensor is about 10 inches long and about 1/10 inch in diameter. The surgery itself requires general anesthesia and takes about 45 minutes to perform.

    When glucose levels are out of whack, a signal is sent to the insulin pump via a wire implanted under the skin -- essentially aping the function of a healthy pancreas.

    So far, so good, says Renard, who implanted the device in two men at the end of last year. They have been followed for seven months and are doing well, he says. Since, then he has implanted the system in five more people.

    "Treating diabetes without injections and without fingersticks sounded, until now, like a dream," says Renard. "But this dream may become a reality"

    Unfortunately, no technique lives up to this promise today. In March, the FDA approved the GlucoWatch, a watch-like device that helps people with diabetes measure their glucose via tiny electric currents. It is "the first step toward noninvasive, continuous glucose monitoring, but it's only a first step," says Robert F. Monoson, MD, chief medical officer of DMCare Inc.

    The problem with the GlucoWatch, he says, is that it does not allow for changes of insulin dosing based on numbers.

    We need a "glucose monitor that's easy to use, continuous, and where the information is transmitted someplace," says Monoson, who has diabetes. To that end, he is helping develop a wireless glucose meter that tells people what their blood sugar is and what they should do about it.

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